Easy Access to Harm Reduction Services and Strengthening Service Provisions Among Female Drug Users Are Essential Needs to Achieve Better Outcomes of Harm Reduction Programs in Myanmar

Introduction: Women who inject drugs often have limited access to harm reduction or general health services. According to a United Nations Office on Drugs and Crime (UNODC) policy document, even though one out of three drug users is a woman, only one out of five drug users in treatment is a woman. . Poverty, conflict, and lack of job opportunities are feeding drug abuse, sex work, human trafficking, and violence against women and children in the northern part of Myanmar. There are fewer female drug users than males, but stigma, discrimination, and subsequent social isolation are more severe for women compared to male drug users, which often holds them back from reaching out for harm reduction services. According to MANA 2016 annual report, 20876 drug users reached MANA's service points by means of outreach services and DIC services for coverage of 15 project locations. By sex distribution, 20168 males were involved by 99% of reached and 708 drug users were females by only 1% involvement

Methods: The study employed structured questionnaires and total of 233 women drug users were interviewed from a list of clients contacted at 15 Harm Reduction project sites of the Myanmar Anti-Narcotics Association (MANA).

Results: All respondents (n = 233) had heard of HIV/AIDS and know about correct condom use, while the risk of sharing needles or syringes was known to most of them. Forty percent of them (n=93) got a blood test, 15.1% (n = 14) got a positive result, and only 35.7% (n = 5) of the respondents who got positive results received ART treatment services. One third of them had multiple sex partners and 19 percent of them had sexual intercourse with men in exchange of money or drugs during last six months. Majority of them (90.9%, n =212) said they do not have the opportunity to use a condom. Only 26% of respondents (n = 61) have accessed methadone maintenance treatment. More than one in every four respondents said they don’t want to come regularly to receive the harm reduction services in Drop in Center.

Conclusions: This study shows that need to build the female-only drop-in-center in Myanmar to encourage more women to take advantage of harm reduction services, and the need to conduct the gender equality awareness sessions in the community.